Bacterial Vaginosis Flashcards
What is the most frequent cause of vaginal discharge among women of child bearing age?
bacterial vaginosis
Give 5 types of bacteria that cause bacterial vaginosis:
1) Gardnerella vaginalis
2) Mycoplasmas
3) Mobiluncus species
4) Anaerobes
5) Provotella species
True or false: bacterial vaginosis is a sexually transmitted infection
false (however, it can increase the risk of women developing sexually transmitted infections)
True or false: bacterial vaginosis increases the risk of acquisition and transmission of HIV
True
Describe the pathogenesis of bacterial vaginosis:
1) Lactobacilli are the main component of healthy vaginal flora and they produce lactic acid that keeps the vaginal pH low (under 4.5)
2) this acidic environment prevents other bacteria from growing
3) when there are reduced numbers of lactobacilli in the vagina, the pH rises, becoming more alkaline, enabling infective anaerobic bacteria to multiply
What is the main component of healthy vaginal flora?
Lactobacilli
Name 3 infections that bacterial vaginosis commonly occurs alongside:
1) candidiasis
2) chlamydia
3) gonorrhoea
Name 5 risk factors for bacterial vaginosis:
1) multiple sexual partners
2) copper coil
3) smoking
4) recent antibiotics
5) excessive vaginal cleaning
Give 3 examples of excessive vaginal cleaning that can cause bacterial vaginosis:
1) vaginal washes
2) harsh cleaning products
3) vaginal douching
What is the key clinical and diagnostic finding for bacterial vaginosis?
fishy-smelling watery grey or white vaginal discharge
True or false: half of women with bacterial vaginosis are asymptomatic
True
What makes the vaginal discharge white and frothy in bacterial vaginsosi?
volatile amine production of the infective bacteria
What examination can be used to better examine discharge in bacterial vaginosis?
speculum
Give two investigations used to diagnose bacterial vaginosis:
1) vaginal pH test
2) vaginal swab for Gram stained microscopy
What is the normal pH of the vagina?
3.5-4.5
What is the pH of the vagina in bacterial vaginosis?
> 4.5
What is a key finding found upon microscopy in bacterial vaginosis?
clue cells
What are clue cells?
epithelial cells from the cervix that have bacteria stuck inside them, usually Gardnerella vaginalis
What antibiotic is used to treat bacterial vaginosis?
Metronidazole
Give two ways that metronidazole can be given in bacterial vaginosis:
1) orally
2) vaginal gel
What is the less-effective alternative to Metronidazole when treating bacterial vaginosis?
Clindamycin
What should patients be advised to avoid when taking Metronidazole?
alcohol
Why should patients avoid alcohol when taking Metronidazole?
it can cause a disulfiram-like reaction (nausea, vomiting, flushing and in severe cases, symptoms of shock and angioedema)
Give 6 complications of bacterial vaginosis in pregnant women:
1) miscarriage
2) preterm delivery
3) post-partum endometritis
4) premature rupture of membranes
5) low birth weight
6) chorioamnionitis
